Illinois Health Matters, July 8, 2008

Illinois Health Matters is a Sargent Shriver National Center on Poverty Law newsletter that describes health care in Illinois through the stories of state residents. Our intent is to show the reality of health care in Illinois. Our hope is that this reality will help Illinois celebrate, use, and safeguard what is already good and drive Illinois toward constant improvement and health care for all.

We want your stories for Illinois Health Matters! We are extremely careful about your confidentiality and will always clear any of your information with you first before we use it. Please click here to share your story (or the story of someone you know) and we will follow up with you. You may also submit stories to:

Melissa Cubria
Direct line: 312.368.1168

MARK

Mark, from Chicago, is 56 years old and self-employed. Nine years ago, he left his job with a large company that offered group coverage. Since then, Mark and his wife have been at the mercy of the private health insurance market. The yearly bill from their insurance carrier tops $15,000 in premiums and $2,500 in deductibles. The cost has gone up 50 percent in the last five years.  In fact, Mark's premiums have gone up every single year since he began coverage with his private insurance company.  Mark and his wife pay more in health care costs than they do on their mortgage payments and real estate taxes.  The irony is that Mark and his wife are extremely healthy and have ever filed a claim with any of their insurance providers through the years though they continue to pay premiums that rise and rise for no apparent reason. In his words, he is appalled that insurance companies "are charging people back into the stone age," regardless of their health.  With gas and food prices skyrocketing, Mark has reached the point where he can no longer afford his premiums, though he fears the potential nightmare of going without insurance so much that he is unwilling to drop coverage. With no reliable system to comparison shop different plans, Mark feels stuck with his current policy as the bills pile up and help is nowhere to be found.  This year there was a bill in Springfield (HB 5865) that would have provided some peace of mind for Mark and the many other state residents that watch their premiums rise for no documented reason. HB 5865 passed the House and is pending in the Senate. The bill would require insurance companies to report how much of the premiums they collect go to health care for beneficiaries versus administrative costs and profits.  This might reign in the spiraling profits and unnecessary costs imposed by the companies.  But hardworking families like Mark's should be able to have a choice that guarantees them affordable comprehensive coverage.  While HB 5865 would help to reign in the greed of the insurance industry, only comprehensive reform will provide affordable choices for everyone. 

CLAIRE

Claire, age 72, lives in Naperville. She moved here from China five years ago and recently began receiving health coverage through Illinois' Medicaid program. She also enrolled in Illinois Health Connect, the Illinois Department of Healthcare and Family Services (HFS) program that connects patients with a Primary Care Provider (PCP) who acts as their medical home and ensures that they are receiving quality, coordinated, cost-effective care. Claire only speaks Mandarin Chinese so she called an organization in DuPage County with bilingual caseworkers for help in choosing a PCP. Her caseworker contacted Illinois Health Connect to find the best fit physician for her client. According to the caseworker, in the past it had been very difficult to find doctors in DuPage County who both speak Mandarin Chinese and accept Medicaid. However, in this particular situation, the caseworker used Illinois Health Connect's database of physicians to locate a culturally competent doctor near Claire's home. She was able help Claire choose her PCP and scheduled an appointment for Claire without much delay. Claire visited her physician for a basic physical exam and was administered medications to treat high blood pressure. Overall, Claire was extremely happy with her doctor and with the treatment plan they developed together. The caseworker was tremendously relieved that she was able to quickly locate a culturally competent physician so convenient for her client. Illinois Health Connect is a cost saving program that has the potential to benefit patients, physicians, caseworkers and all Illinois residents, by enabling people like Claire to receive preventative care and disease management services.

Illinois Health Matters
Issue 5
July 8, 2008